Pharmacology for Dentistry

(Ben Green) #1
8 Section 1/ General Principles of Pharmacology


  • Maintenance of therapeutic effect for
    longer time.

  • To some extent decreased incidence of
    undesired effects.

  • Appropriate for drugs with short half
    lives (less than 4 hours).


Sublingual Administration
The highly lipid soluble and
nonirritating drugs (i.e. nitroglycerine,
isoprenaline, methyltestosterone) in the
form of tablets or pellet is placed under the
tongue, where they rapidly dissolve and are
absorbed quickly in the general circulation.
The advantages of this routes are:



  • Rapid onset of action.

  • The degradation and metabolism of the
    drugs in the stomach and liver is
    avoided


PARENTERAL ROUTES


(par = beyond, enteral = intestinal)


The administration of drugs by injection
directly into the tissue fluid or blood without
having to cross the intestinal mucosa.


The advantages of parenteral routes are:



  • Rapid action of drug.

  • Can be employed in unconscious/
    uncooperative patients.

  • Drugs, which are modified by
    alimentary juices and liver can be given
    by this route.

  • Drugs, which are not absorbed in small
    intestine or irritate the stomach can be
    administered by this route.


Disadvantages are:



  • Less safe, more expensive.

  • Inconvenient (painful) for the patient.

    • Self medication is difficult.

    • Chances of local injury at the site of
      injection.
      The important parenteral routes are:




Subcutaneous
The non-irritant substances can be
injected by this route. The rate of
absorption of drug is constant and slow to
provide a sustained effect. The site of
injection is usually the outer surface of the
arm, or front of the thigh. Self medication
(e.g. insulin) is possible because deep
penetration is not needed. Other drugs
which are administered subcutaneously are
adrenaline, morphine and certain hormonal
preparations.
The other related subcutaneous routes
are dermojet (by which, drug is projected
from a microfine orifice using a high ve-
locity jet) and pellet implantation (which
provides sustained release of the drug
over weeks and months e.g. testosterone).

Intramuscular
The soluble substances, mild irritants
and suspensions can be injected by this
route in the large skeletal muscles (deltoid,
triceps, gluteus maximus, rectus femoris
etc.). These muscles are less richly supplied
with sensory nerves and are more vascular,
so irritant solutions can be injected. Small
volumes (up to 2 ml) are injected into the
deltoid muscle, and small or large volumes
(up to 10 ml) are injected into the gluteal
mass.
The rate of absorption is reasonably
uniform and the onset of action is rapid.
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